Honey prophylaxis reduces the risk of endophthalmitis during perioperative period of eye surgery.

Endophthalmitis following eye surgery remains a rare but serious complication. Topical fluoroquinolones have been used as prophylactic agents against endophthalmitis. However, the emerging resistance of ocular pathogens to fluoroquinolones may preclude their routine use. Honey, a natural antimicrobial product with wound healing properties, is a promising candidate for the prophylaxis of endophthalmitis. The goal of this study was to determine whether 25% (w/v) honey solution is effective in eradicating bacterial ocular pathogens in the perioperative period in patients scheduled for cataract surgery or vitrectomy, and to compare its efficacy to 0.3% ofloxacin. In this pilot study, 101 patients were randomized to honey (n = 49) or ofloxacin (n = 52) treatment. In both groups, eye drops were administered five times a day for 7 days before and 5 days after surgery. Before administration of the antibacterial agents, 18 and 25 isolates were detected in the ofloxacin and honey group, respectively. After 7 days of administration, four isolates (coagulase-negative Staphylococcus) were detected in each therapeutic group. No significant difference in antibacterial effect was found between groups. These results indicate that honey may act as a prophylactic agent of endophthalmitis; however, further studies are needed to characterize its ocular penetration properties.